Nurse-Family Partnership (NFP)® Meets HHS Criteria

Model effectiveness research report last updated: 2019

In brief

Evidence of model effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

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Model description

The Nurse-Family Partnership (NFP) is designed for first-time, low-income mothers and their children. It includes one-on-one home visits by a trained registered professional nurse to participating clients. The visits begin early in the woman’s pregnancy (with program enrollment no later than the 28th week of gestation) and conclude when the woman’s child turns 2 years old. NFP is designed to improve (1) prenatal and maternal health and birth outcomes, (2) child health and development, and (3) families’ economic self-sufficiency and/or maternal life course development. For more information, please read the Model Overview.

This report also includes a review of an alternate implementation of NFP, which had paraprofessionals, rather than nurses, conduct the home visits. The paraprofessionals received the same length of training as the nurses and carried the same caseloads, but had a higher supervisor-to-home visitor ratio.

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Extent of evidence

Nurse-Family Partnership (NFP)®
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
47
  …and at least one finding rated high
22
  …and at least one finding rated moderate (but none rated high)
6
  …and all findings that were eligible for review rated low
16
  …but manuscript is additional source2
3
NFP with Nurse Home Visitors - Mothers with low psychological resources subgroup
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
6
  …and at least one finding rated high
5
  …and at least one finding rated moderate (but none rated high)
1
  …and all findings that were eligible for review rated low
0
  …but manuscript is additional source2
0
NFP with Paraprofessional Home Visitors
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
4
  …and at least one finding rated high
3
  …and at least one finding rated moderate (but none rated high)
0
  …and all findings that were eligible for review rated low
1
  …but manuscript is additional source2
0
NFP with Paraprofessional Home Visitors - Mothers with low psychological resources subgroup
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
2
  …and at least one finding rated high
2
  …and at least one finding rated moderate (but none rated high)
0
  …and all findings that were eligible for review rated low
0
  …but manuscript is additional source2
0

1When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

2Additional sources have findings or details that perfectly overlap with another manuscript and are not rated.

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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Summary of findings

To see details on each finding HomVEE reviewed in well-designed research, click on the name of an outcome domain in the tables below. Findings rated low quality by HomVEE are not summarized here.

Nurse-Family Partnership (NFP)®
Outcomes
Findings

Outcome Child Development and School Readiness

Findings:
Favorable: 13
No effect: 127
Unfavorable or ambiguous: 2

Outcome Child Health

Findings:
Favorable: 6
No effect: 39
Unfavorable or ambiguous: 2

Outcome Family Economic Self-Sufficiency

Findings:
Favorable: 12
No effect: 78
Unfavorable or ambiguous: 2

Outcome Linkages and Referrals

Findings:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 1

Outcome Maternal Health

Findings:
Favorable: 26
No effect: 88
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Findings:
Favorable: 7
No effect: 30
Unfavorable or ambiguous: 0

Outcome Reductions In Child Maltreatment

Findings:
Favorable: 7
No effect: 19
Unfavorable or ambiguous: 0

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Findings:
Favorable: 8
No effect: 55
Unfavorable or ambiguous: 0
NFP with Nurse Home Visitors - Mothers with low psychological resources subgroup
Outcomes
Findings

Outcome Child Development and School Readiness

Findings:
Favorable: 22
No effect: 44
Unfavorable or ambiguous: 0

Outcome Child Health

Not measured

Outcome Family Economic Self-Sufficiency

Findings:
Favorable: 0
No effect: 6
Unfavorable or ambiguous: 1

Outcome Linkages and Referrals

Not measured

Outcome Maternal Health

Not measured

Outcome Positive Parenting Practices

Not measured

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured
NFP with Paraprofessional Home Visitors
Outcomes
Findings

Outcome Child Development and School Readiness

Findings:
Favorable: 0
No effect: 34
Unfavorable or ambiguous: 0

Outcome Child Health

Findings:
Favorable: 1
No effect: 1
Unfavorable or ambiguous: 0

Outcome Family Economic Self-Sufficiency

Findings:
Favorable: 1
No effect: 9
Unfavorable or ambiguous: 0

Outcome Linkages and Referrals

Not measured

Outcome Maternal Health

Findings:
Favorable: 3
No effect: 11
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Findings:
Favorable: 1
No effect: 3
Unfavorable or ambiguous: 0

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Findings:
Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0
NFP with Paraprofessional Home Visitors - Mothers with low psychological resources subgroup
Outcomes
Findings

Outcome Child Development and School Readiness

Findings:
Favorable: 4
No effect: 33
Unfavorable or ambiguous: 0

Outcome Child Health

Not measured

Outcome Family Economic Self-Sufficiency

Not measured

Outcome Linkages and Referrals

Not measured

Outcome Maternal Health

Not measured

Outcome Positive Parenting Practices

Not measured

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured

The section above focuses on findings from the full sample in a study. Subgroups that have been replicated in distinct samples also have findings reported above. HomVEE does not report the findings of non-replicated subgroups. Beginning with research reviewed in 2021, however, HomVEE, lists those subgroups on the details page of each manuscript that had at least one finding that rated moderate or high.

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Criteria established by the U.S. Department of Health and Human Services

Information based on comprehensive review of all high- and moderate-rated manuscripts
Nurse-Family Partnership (NFP)®
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.		Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.		Yes
NFP with Paraprofessional Home Visitors
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.		Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.		Yes

Notes: If the model does not meet criterion 3 but meets criteria 1 and 2 based on findings from subgroups, the impacts must be replicated in the same domain in two or more studies using non-overlapping analytic study samples. HomVEE assesses and reports criteria 4 and 5 for all models that have well-designed research, but meeting those two criteria is only required of models for which all findings are from randomized controlled trials. Please read the HHS criteria for evidence-based models for more information.

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